HomeMy WebLinkAboutPermit Electrical 1995-2-1
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ep?'Oya. ~ ~ ELECTRICAL PERMIT APPLICATION
97477 2on1n":1::,(' Q4V1loq
72~-;jG~~ ~ -fV'-....__Ci-ty. Job Number . n ' .
S'"n;:.\U,e~
AutnorlzQd '" 3. COMPLETE FEE SCHEDULE BE LOll
1. LOCATION, OF ,INSTALLATION
~7~ l~~ tllu,Mnrt A. New Residential-Single or
.~\ Multi-Family per dwelling unit.
\Gjc5~10~! oJ4fy) Service Included,
\ ~D~S<m~ -PO~
225 FIFTH STREET
SPRINGFIELD, OREGON
INSPECTION REQUEST:
OFFICE: 726-3759
Perm~ts are non-transferable and expire
if work is not started within 180 days
of issuance or if. work is suspenaed for
180 days.
2.-' CONTRACTOR INSTALLATION ONLY
Electrical Contractor O..vlL~
~'-IId... ~,JJ~)
Address
Ci ty .;;;;:--; -'--' J 67J, Phone 6;)'8 - )..0'19
Supervisor License Number 6 '7;Y-.:5
Expiration Date 10-1- 16
Constr Contr. Number #f70d
Expiration Date 1- J.3 - 9t
Signature of Supervising Electrician
I;)~ K J .,~ "
0".", "., ~uJO~--lV
Address _,~() ~ ~ ~ D of)
City ~fi -=;:;e~
OI1NE;~~ALLATION
The installation is being made on
property I own which is not intended
for sale, lease or rent.
.
Owners Signature:
D~TE~---------~--~~-r~--:-----~-
IU:CI;rl'T II:~_~ I \\t1\, 1_1
RbCHVED BY-7 1lJ.Jfl/
1000 sq.ft. or less
Each additional 500
sq. ft or portion
thereof
Each Manuf'd Home or
Modular Dwelling
Service or Feeder
B. Services or Feeders
Installation, Alterations
or.- Relocation:
200 amps or less
201 amps to 400 amps
401 amps to 600 amps
601 amps to 1000 amps
Over 1000 amps/volts
Reconnect Only
Items
Cost
Sum
$ 85,00
$ 15.00
$ 40,00
$ 50,00
$ 60.00
$100.00
$130.00
$300.00 .L\'
$ 40.00 :{'LL.
C.
Temporary Services or Feeders
Installation, Alteration or Relocation
200 amps or less
201 amps to 400 amps
Over 401 to 600 amps
Over 600 amps or 1000 volts
D.
Branch Circuits
New, Alteration or Extension Per Panel
$ 35.00
Miscellaneous (Service/feeder
-Each installation
Pump or irrigation
Sign/Outline Lighting
Limited Energy/Res
Limited Energy/Comm
One Circuit
Each Addi tional
Circuit or with Service
or Feeder Permit
E.
5.
SUBTOTAL OF ABOVE
5% State Surcharge
3% Administrative Fee
TOTAL
$ 40.00,
$ 55.00- .'
$ 80.00
see liB" above
$ 2,00
no t included)
$ 40.00
$ 40.00
$ 20.00
$ 36.00
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